BACKGROUND: Although smoking and alcohol consumption are the major risk factors for upper aerodigestive tract cancers, observational studies indicate a protective role for fruits, vegetables, and antioxidant nutrients. METHODS: The authors examined whether daily supplementation with 50 mg dl alpha-tocopheryl acetate and/or 20 mg beta-carotene reduced the incidence of or mortality from oral/pharyngeal, esophageal, and laryngeal cancers in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) study, a double-blind, placebo-controlled primary prevention trial conducted in southwestern Finland. A total of 29,133 male smokers, aged 50-69 years and free of cancer at baseline, were randomized in a 2 x 2 factorial design to the supplementation regimen for 5-8 years (median, 6.1 years). Incident cancers of the oral cavity and pharynx (n = 65), esophagus (n = 24), and larynx (n = 56) were identified through the Finnish Cancer Registry. Intervention effects were assessed using survival analysis and proportional hazards models. RESULTS: There was no effect of either agent on the overall incidence of any upper aerodigestive tract cancer. For larynx, however, exploratory subgroup analyses were suggestive of a protective effect of beta-carotene supplementation on the incidence of early stage malignancies (stage I, relative risk [RR], 0.28, 95% confidence interval [CI]: 0.10-0.75). Neither agent affected mortality from these neoplasms. CONCLUSIONS: The results do not provide support for a protective effect of vitamin E or beta-carotene supplementation on upper aerodigestive tract cancers, although beta-carotene supplementation may impact the incidence of some subtypes of laryngeal tumors.
RCT Entities:
BACKGROUND: Although smoking and alcohol consumption are the major risk factors for upper aerodigestive tract cancers, observational studies indicate a protective role for fruits, vegetables, and antioxidant nutrients. METHODS: The authors examined whether daily supplementation with 50 mg dl alpha-tocopheryl acetate and/or 20 mg beta-carotene reduced the incidence of or mortality from oral/pharyngeal, esophageal, and laryngeal cancers in the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) study, a double-blind, placebo-controlled primary prevention trial conducted in southwestern Finland. A total of 29,133 male smokers, aged 50-69 years and free of cancer at baseline, were randomized in a 2 x 2 factorial design to the supplementation regimen for 5-8 years (median, 6.1 years). Incident cancers of the oral cavity and pharynx (n = 65), esophagus (n = 24), and larynx (n = 56) were identified through the Finnish Cancer Registry. Intervention effects were assessed using survival analysis and proportional hazards models. RESULTS: There was no effect of either agent on the overall incidence of any upper aerodigestive tract cancer. For larynx, however, exploratory subgroup analyses were suggestive of a protective effect of beta-carotene supplementation on the incidence of early stage malignancies (stage I, relative risk [RR], 0.28, 95% confidence interval [CI]: 0.10-0.75). Neither agent affected mortality from these neoplasms. CONCLUSIONS: The results do not provide support for a protective effect of vitamin E or beta-carotene supplementation on upper aerodigestive tract cancers, although beta-carotene supplementation may impact the incidence of some subtypes of laryngeal tumors.
Authors: Qian Li; Shu-Chun Chuang; Jose Eluf-Neto; Ana Menezes; Elena Matos; Sergio Koifman; Victor Wünsch-Filho; Leticia Fernandez; Alexander W Daudt; Maria Paula Curado; Deborah M Winn; Silvia Franceschi; Rolando Herrero; Xavier Castellsague; Hal Morgenstern; Zuo-Feng Zhang; Philip Lazarus; Joshua Muscat; Michael McClean; Karl T Kelsey; Richard B Hayes; Mark P Purdue; Stephen M Schwartz; Chu Chen; Simone Benhamou; Andrew F Olshan; Guopei Yu; Stimson Schantz; Gilles Ferro; Paul Brennan; Paolo Boffetta; Mia Hashibe Journal: Int J Cancer Date: 2012-01-27 Impact factor: 7.396
Authors: V Edefonti; M Hashibe; M Parpinel; M Ferraroni; F Turati; D Serraino; K Matsuo; A F Olshan; J P Zevallos; D M Winn; K Moysich; Z-F Zhang; H Morgenstern; F Levi; K Kelsey; M McClean; C Bosetti; S Schantz; G-P Yu; P Boffetta; S-C Chuang; Y-C A Lee; C La Vecchia; A Decarli Journal: Br J Cancer Date: 2015-05-19 Impact factor: 7.640